Diagnosis of EBV and HCMV infections in pediatric heart transplant recipients.

BACKGROUND

Viral infections, including human cytomegalovirus (HCMV) and Epstein–Barr Virus (EBV), are significant agents that can cause serious complications and death in heart transplant recipients. This study aims to detect CMV and EBV infections in pediatric heart transplant recipients.

METHODS

We conducted a cross-sectional study involving 28 hospitalized children who were candidates for heart transplantation. Plasma samples were collected at three time points: during surgery, one month after transplantation, and two months after transplantation. Urine samples were collected two months post-transplant. Heart tissue specimens from donors were taken from the aorta wall, pulmonary artery, and left atrium. Molecular tests were performed to detect EBV and CMV infections and viral loads. The patients’ clinical information was recorded and analyzed.

RESULTS

All 28 patients were CMV seropositive (100%), and 64.28% had EBV-IgG. CMV infection was detected in 10.7%, 7.1%, and 7.1% of plasma samples at the three time points, respectively, and in 7.1% of urine samples two months post-transplant. EBV infection in plasma was more frequent than CMV, with detection rates of 25%, 22.2%, and 25% at the three time points, respectively. Two recipients (7.1%) received CMV-infected heart tissue, and four patients (14.3%) received EBV-infected heart tissue.

CONCLUSION

The immunosuppressive state in solid organ transplantation can trigger the reactivation and re-infection of CMV and EBV, leading to CMV disease and EBV-associated complications in heart transplant recipients. Our findings emphasize the need for long-term monitoring, effective prophylactic strategies, and a balanced approach to immunosuppression to mitigate the risks associated with these viral infections.